Provider Demographics
NPI:1548406242
Name:DAVID C LARNED MD PA
Entity type:Organization
Organization Name:DAVID C LARNED MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D. P.A.
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:LARNED
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:302-655-7600
Mailing Address - Street 1:2300 PENNSYLVANIA AVE STE 3A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1379
Mailing Address - Country:US
Mailing Address - Phone:302-655-7600
Mailing Address - Fax:302-655-4900
Practice Address - Street 1:2300 PENNSYLVANIA AVE STE 3A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1379
Practice Address - Country:US
Practice Address - Phone:302-655-7600
Practice Address - Fax:302-655-4900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10002601207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE141108Medicare PIN